Malaria: Causes, Symptoms, and a Guide to ​Prevention

Malaria: Causes, Symptoms, and a Guide to ​Prevention

Malaria is a disease that threatens human life, and it has been around for thousands of years. While it occurs almost exclusively in tropical and subtropical areas, its effects are felt globally. More than 240 million people became infected with malaria in 2020, and it caused over 620,000 deaths. It is important to understand malaria because the world is more interconnected than ever—travel and climate change impact disease risk and behavior. This complete guide to malaria will provide you with information. You will learn what causes malaria; how it is transmitted; its signs and symptoms; the treatment options; and, most importantly, prevention.

What is malaria?

Malaria is a parasitic disease caused by Plasmodium parasites. Humans are infected with malaria after being bitten by a female Anopheles mosquito. The parasite goes through several stages of development inside the mosquito before being transferred into the human bloodstream. Once inside the person, it develops in the liver, and then the parasites enter the bloodstream and infect red blood cells. The infection in the blood causes various effects, and if left untreated it can result in various symptoms until eventually, it may cause death.

There are five Plasmodium species that infect humans:

1. Plasmodium falciparum – The most severe and deadly species.

2. Plasmodium vivax – common in Asia and Latin America; predominately a relapsing infection.

3. Plasmodium ovale – Mainly found in West Africa.

4. Plasmodium malariae – Causes milder infection and has a longer incubation period.

5. Plasmodium knowlesi – A type of zoonotic malaria, mostly located in Southeast Asia.

How Does Malaria Get Transmitted?

Malaria is mainly transmitted through the bite of an infected Anopheles mosquito. Anopheles mosquitoes are night biters, typically from dusk until dawn. When a mosquito bites a person who has malaria it takes up the parasites with blood when it feeds. The parasites then develop in the mosquito, and the mosquito bites and transmits the parasites to the next person.

Mosquito transmission is the primary method of transmission of malaria. There are other rare methods of transmission including:

Blood transfusion from an infected donor.

Sharing needles or syringes with infected blood.

Congenital transmission where a mother transmits malaria to her baby during birth.

Global Context / Risk Areas

Even though malaria is not common in the United States, travelers abroad and military personnel traveling to endemic areas are at risk. The highest number of cases of malaria are being reported in countries from sub-Saharan Africa, south Asia, Central and South America, the Middle East and parts of south-east Asia. Climate change and mosquito migration are raising concerns for the potential spread of malaria into new areas.

The Symptoms of Malaria

The symptoms of malaria usually occur from 10 to 15 days after a mosquito has bitten the person and acquired the infection. However, in certain cases, the parasite can remain dormant in the liver and activate after weeks or months. 

Common Symptoms Include:

✅High fever

✅Chills and shivering

✅Sweating

✅Headache

✅Nausea and vomiting

✅Stomach pain

✅Muscle and joint pain

✅Tiredness

✅Fast breathing

✅Diarrhea

In severe cases of malaria, especially from P. falciparum, complications may include:

✅Cerebral malaria (where patient has brain damage or coma)

✅Severe anemia

✅Kidney failure or liver failure

✅Hypoglycemia (low blood sugar)

✅Respiratory distress

Early detection and treatment are essential to prevent life-threatening complications

Diagnosis Of Malaria

When malaria is suspected, particularly for anyone who has traveled to a region where malaria carries high risk, health care providers generally request:

Microscope blood smears to identify the presence of malaria parasites

Rapid diagnostic tests (RDTs) that identify parasite plasmodium antigen

Polymerase chain reaction (PCR) testing to confirm the species of plasmodium (where available)

The diagnostic tests help identify the type of Plasmodium infection, and help identify which treatment is best.

Treatment options for malaria

Malaria is treatable, but which treatment depends on a number of factors including the parasite species (looking for routing effective treatments), if the patient is symptomatic, and then the age, weight, and pregnancy status of the patient.

Some common Antimalarial medications:

1. Artemisinin-based combination therapies (ACTs) - First-line treatment for P. falciparum malaria.

2. Chloroquine - Effective for P. vivax, P. ovale and P. malariae if there is no resistance.

3. Primaquine - Used primarily to prevent relapse from the dormant form of  1. P. vivax and P. ovale

4. Mefloquine, atovaquone-proguanil, and doxycycline- Used for treatment or prevention depending on the situation. 

It may be necessary to hospitalize severe malaria cases to administer IV antimalarial drugs. 

Prevention: How Can I Protect Myself From Malaria

Preventing malaria is far more advantageous than treating it. For residents of the U.S. traveling to endemic areas, certain aspects of prevention can minimize the chance of infection. 

1. Use Mosquito Repellents 

Use repellents that are EPA-approved that contain DEET, picaridin or IR3535. 

Reapply as instructed, especially in humid weather or after excessive sweating.

2. Sleep Under Insecticide-Treated Bed Nets (ITNs) 

Bed nets provide physical protection from mosquitoes. 

An insecticide-treated net will kill or deter mosquitoes by contact. 

3. Take Antimalarial Medications as Prophylaxis

Travelers should visit their physician for a check up or guidance 4–6 weeks prior to travel. 

Examples of common preventive medications include atovaquone-proguanil, doxycycline and mefloquine. 

4. Wear Protective Clothing 

Wearing a long-sleeved shirt, a long pant, and socks can reduce instances of mosquito bites. 

Clothing can be treated with permethrin, which also offer some protection from mosquitoes. 

5. Take Indoor Protective Measures

Use window and door screens.

Employ insecticides indoors or the use of mosquito coil macerators. 

Malaria and Climate Change: An Increasing Concern 

Climate change is becoming an increasing cause for diversity in malaria transmission. Temporary climate changes, such as increased unsustainable temperatures and rainfall The expansion of mosquito habitats, creating conducive conditions for Anopheles mosquitoes in areas previously considered low-risk, could lead to the possibility of local. 

Transmission in parts of the southern U.S. States, areas in Europe and higher altitudes in Africa. As new and emerging areas likely to become at risk, add avoidable locality . 

With the possibility of increasing what were previously considered low-risk habitats, we could see southern U.S. States, parts of Europe＇ and newly emerging higher altitudinal areas of Africa become areas of local transmission and added risk. The use of surveillance and public health treatments are critical in these newbies areas.

Malaria: United States

Malaria is not endemic in the U.S., but the U.S. has approximately 2,000 cases of malaria each year, 

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A handful of locally acquired cases have occurred in the US — e.g. , Florida and. Texas as well as locally acquired cases in ( 2023). 

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The Centers for Disease Control and Prevention (CDC) continues to monitor malaria annually and provide information on how to diagnose, have treatment and prevention of the infection.

Vaccine Development: The New Frontier

 

490: In October 2021, the World Health Organization (WHO) approved the RTS,S/AS01 (Mosquirix) vaccine for children at risk. To date, the approval of RTS,S/AS01 was a major milestone in malaria prevention. While the vaccine only reduced cases of P. falciparum malaria by approximately 30% in children, this was nevertheless significant!

Newer vaccines — R21/Matrix-M — Waste more effective in clinical, trials have launched across various African countries. These vaccines are not yet available globally, but still support an optimistic outlook for the anti- malaria movement.

Quick Facts Regarding Malaria for Travelers and Families

 The information below is intended to provide basic information about malaria. 

Topic Key facts

Incubation period 10 to 15 days

High-risk times Night (dusk to dawn)

Endemic regions Sub-Saharan Africa, Asia, Latin America

First-line treatment ACTs (artemisinin-based combination therapy)

Effective repellents DEET, Picaridin

Preventive meds Atovaquone-proguanil, Doxycycline, Mefloquine

Most affected population Children under 5 are most at risk

Best prevention Drugs, nets, repellents, clothing

Conclusion: Malaria Is Preventable and Treatable

As a public health threat, malaria is still a major concern; especially in developing countries, it remains a major health concern. But malaria is both preventable and treatable, if you have right knowledge and tools. If you are traveling to or living in an endemic region take measures that are proactive (e.g., bed nets, repellents, antimalarial medications) and you can save your life.

The world is still at risk from malaria. Awareness by health workers, early diagnosis, effective treatments and vaccines are methods we can use to curb the global burden of malaria. If we act together, and take responsibility, malaria could be eradicated in our lifetime.